精浆C反应蛋白测定在男性附性腺慢性炎症诊疗中的意义

目的探讨C反应蛋白(CRP)在男性附性腺慢性炎症诊疗中的临床意义。方法采集41例慢性前列腺炎、附睾炎、精囊炎患者精浆进行CRP测定,与77例其他不育症患者和31例有生育能力的正常男性精浆CRP进行对照,并对病例组病人治疗前后的精浆CRP进行对比。结果(1)病例组精浆CRP(69.55±23.16)mg/L,不育组与生育组精浆CRP分别为(3.82±2.67)mg/L、(4.55±3.62)mg/L。病例组精浆CRP显著高于不育组与生育组(P<0.01);(2)病例组治疗后精浆CRP明显下降,接近正常。结论精浆CRP测定在男性附性腺慢性炎症诊疗中有重要临床意义。     

精浆蛋白电泳带谱分析对梗阻性无精子症的定位诊断价值

目的：评估精浆蛋白电泳带谱对梗阻性无精子症的定位诊断价值。方法：对28例正常生育男子和21例梗阻性无精子症患者(包括14例双侧输精管结扎和7例双侧附睾尾梗阻)，采用不连续SDS-PAGE分析精浆蛋白带谱变化，并分别测定精浆总蛋白质含量。结果：正常生育男子与梗阻性无精子症者比较，虽然总蛋白质含量有差异(P＜0．05)，但精浆蛋白带谱分析基本相同。结论：精浆蛋白电泳带谱分析对梗阻性无精症的诊断及定位无临床意义。     

精浆蛋白质电泳两种分析方法的探讨

目的:探讨琼脂糖电泳和SDS-琼脂糖电泳分析精浆蛋白质的临床可行性。方法:69例不育患者精液标本按常规和特殊检查结果分为弱畸精子症(n=19)、弱精子症(n=22)和相对正常(n=28)3组,然后离心分离获取精浆。分别采用琼脂糖和SDS-琼脂糖作介质,不同的点样时间、迁移功率,酸性结晶紫和氨基黑两种染色,对精浆蛋白质进行检测,将电泳图谱进行吸光度仪扫描并将结果对比分析。结果:以SDS-琼脂糖作介质,酸性结晶紫染色可将精浆分为4条带,但区带弥散,相互间拖尾严重;以琼脂糖作介质,pH 9.2碱性缓冲条件,点样6 m in,可将精浆分为A、B、C、D、E、F 6条带,氨基黑染色后,区带清晰,间隔适当,易于吸光度仪分析相对含量,重复性好。电泳结果经方差分析,弱精子症组与相对正常组、弱畸精子症组在C与E带上均有差别,而相对正常组与弱畸精子组无差别;同时,相对正常组标本之间的电泳图谱也有显著的不同。结论:以琼脂糖作介质,在碱性缓冲条件下电泳,氨基黑染色来分离检测精浆蛋白质具有较高的可行性,该方法操作简单、快速,可适合临床常规开展。     

不育症患者精浆Lep与IGF-1浓度测定的意义

目的探讨精浆中瘦素(Lep)和胰岛素样生长因子-1(IGF-1)浓度对精子密度、运动能力等指标的影响。方法应用放射免疫分析(RIA)和免疫放射分析(IRMA)技术对126例不育和30例生育男性血清与精浆中的lep和IGF-1含量进行了检测。结果精浆lep在不育症组中的含量明显高于生育组(P<0.05),IGF-1在不育症组中的含量明显低于生育组(P<0.01)。血清lep含量不育症组高于生育组,其中无精子症组与生育组之间存在显著性差异(P<0.05);IGF-1含量不育症组与生育组之间差异无显著性(P>0.05)。精浆中lep含量与IGF-1含量之间存在明显的负相关(P<0.01)。结论精浆中的lep和IGF-1浓度与精子的密度、活动力、活动率之间均存在密切关系,精浆中lep的高浓度和IGF-1的低浓度可直接作用于睾丸,影响精子的形成和精子获能。检测精浆中lep和IGF-1浓度对于判断男性的生殖状态具有重要价值。     

男性不育患者精浆转铁蛋白含量测定

人类精浆中包含着大量的由支持细胞分泌的转铁蛋白(Transferrin,Tf)。本文采用单向免疫扩散法测定了50例生育男性、56例妻子流产的男性及143例不育男性精浆Tf含量。结果表明精子密度、活动力、活动率等皆与精浆Tf含量呈正相关;正常生育男性的精浆Tf含量与不育男性有高度显著性差异(P<0.01),而与妻子流产的男性则无明显差异(P>0.05)。精浆Tf含量测定有助于评价精子质量,可以作为反映支持细胞功能的特异性指标。     

前列腺按摩液/精浆弹性蛋白酶联合诊断ⅢA型前列腺炎合并不育症的价值

目的:探讨前列腺按摩液(EPS)/精浆弹性蛋白酶(NE)联合诊断ⅢA型前列腺炎合并不育症的价值。方法:2015年5月至2017年3月分别遴选已生育ⅢA型前列腺炎患者(生育组)62例、ⅢA型前列腺炎合并不育症患者(不育组)67例,和无泌尿生殖道疾病对象(对照组)57例,检测其EPS和精浆中NE含量、精液常规、EPS常规及症状评分(CPSI);二元Logistic回归分析EPS/精浆的NE比值。结果:诊断ⅢA型前列腺炎合并不育症的联合预测因子为(精浆NE-2×EPS NE)。对129例ⅢA型前列腺炎患者(病例组)的相关性分析显示,联合预测因子与EPS的白细胞(WBC)呈负相关(r=-0.914,P0.01),与症状评分、精子浓度、精子活率、精子活力呈负相关(P均0.01),与精浆WBC、精液pH值的关联无统计学意义(P0.05)。该预测因子在生育组、不育组、对照组中均值和95%置信区间分别为-2 238(-2 595,-2 054)、-1 511(-1 778,-1 307)、-148(-181,-118),在病例组(生育组+不生育组)和对照组间、病例组内生育组和不育组间差异有统计学意义(P0.01)。联合预测因子诊断ⅢA型前列腺炎合并不育症的受试者工作特征曲线(ROC)面积为0.71(P0.01)。结论:EPS NE和精浆NE含量联合诊断ⅢA型前列腺炎合并不育症有较大诊断价值,使用联合预测因子优于单独采用EPS NE或精浆NE含量诊断IIIA型前列腺炎合并不育症。     

精浆蛋白平板电泳带谱分析诊断男性不育症的临床意义

观察２２例生育男性的精浆ＳＤＳ－聚丙烯酰胺平板凝胶电泳至少可区分６条蛋白带，分别位于分子量７０、６２、５０、４５、３０和１５ｋｄ处。另５４例不育男性精浆电泳结果显示８例分别缺失以上各蛋白带，缺失带患者占不育男性的１４．８％。初步认为这些带的缺失与生殖管道梗阻，精液不液化及精子活动力低下有关。该方法检测精浆蛋白操作简便，所获带谱丰富，分辨率高，重复性好，结果客观可靠，值得在不育症病因诊断中推广应用。     

精浆转铁蛋白含量与不育的关系

为探讨精浆转铁蛋白 (Tf)含量与男性生育力的关系 ,采用速率散射比浊法 ,对 2 0例正常生育男性和 96例不育男性精浆Tf含量进行了测定 ,同时做精子密度、精子活动率及精子顶体完整率 (PIA)分析。结果表明少精子组 (精子密度 <2 0× 10 6/ml)精浆Tf含量较生育组与正常密度组 (精子密度≥ 2 0× 10 6/ml)显著低 (P <0 .0 1) ;精浆Tf含量与精子活动率无关 ;正常精子密度的不育患者精子PIA <80 %组精浆Tf的含量显著低于PIA≥ 80 %组(P <0 .0 1)。提示精浆Tf含量的下降与男性生育力有关     

人精浆中铁蛋白与β_2-微球蛋白测定及临床意义

目的 :探讨精浆中铁蛋白 (Fer)和 β2 微球蛋白 (β2 MG)含量与不育症的关系。　方法 :用放射免疫分析方法对 2 2例正常生育者和 12 5例不育者精浆中Fer和 β2 MG进行了检测。　结果 :不育男性精浆中Fer含量明显高于正常生育组 ,β2 MG含量明显低于生育组 ,不育与生育者之间存在高度显著性差异 (P <0 0 1) ,并且精浆中Fer与 β2 MG含量与精子密度之间存在密切的相关关系。　结论 :测定精浆中Fer与 β2 MG含量可以帮助判断男性不育者的状态 ,指导临床对其进行有效的治疗     

不育病人精浆胆固醇酯转运蛋白的检测

目的 :检测不育病人精浆胆固醇酯转运蛋白 (cholesterolestertransferprotein ,CETP)的含量 ,并探讨其与不育的关系。　方法 :随机选择 163例不育病人及 15例生育男性 ,行精液常规分析及精浆CETP浓度测定 ,其中5 5例不育病人同时测定了血清CETP含量。　结果 :不育病人及生育男性精浆CETP含量分别为 ( 2 .2 1± 1.2 3 )μg/L和 ( 1.40± 0 .45 ) μg/L ,两组间差异无显著性 (P >0 .0 5 ) ;在不育病人中 ,无精子症组 (n =2 9)、少弱精子症组(n =5 8)、少精子症组 (n =15 )、弱精子症组 (n =44 )及正常精子症组 (n =17)间CETP含量差异也无显著性 (P >0 .0 5 )。精浆平均CETP含量仅占血清的 1/ 10 0 0 ,不育病人精浆及其血清CETP含量间并无相关性 (r =0 .0 0 9,P>0 .0 5 )。　结论 :精浆CETP含量极低 ,与精子密度、活率的改变无关 ,可能保证了精子在未进入女性生殖道前膜结构与功能的完整性     

男性不育患者精浆尿酸的检测及临床意义初探

目的 :检测男性不育患者精浆尿酸的含量 ,并探讨其与不育的关系。　方法 :2 0 0 3年 2～ 8月就诊的男性不育患者 1 6 3例 ,分为 4组 :梗阻性无精子症组 ,1 5例 ;非梗阻性无精子症组 ,36例 ;少精子症组 ,4 3例 ;弱精子症组 ,6 9例。 2 0例正常生育男性为正常对照组。上述各组均作精液参数分析及精浆尿酸含量的测定。　结果 :正常对照组精浆尿酸含量为 (396 .9± 5 3.1 ) μmol/L ,显著高于梗阻性无精子症组 [(79.5± 1 8.1 ) μmol/L]、非梗阻性无精子症组[(2 4 5 .8± 76 .5 ) μmol/L]、少精子症组 [(2 6 2 .2± 79.2 ) μmol/L]和弱精子症组 [(2 5 1 .4± 75 .4 ) μmol/L](P均 <0 .0 1 )。其中 ,梗阻性无精子症组精浆尿酸含量又显著低于其他各不育症组 (P均 <0 .0 1 ) ,其余各不育症组间精浆尿酸含量差异无显著性 (P >0 .0 5 )。　结论 :精浆中尿酸作为生殖系统中的一种重要抗氧化物 ,可能在男性生殖中具有一定意义。     

生育与不育男性精浆总抗氧化能力分析

目的:分析生育与不育男性精浆中总抗氧化能力(TAC)及其在男性生育中意义。方法:225例男性不育患者分为6组,分别为:梗阻性无精子症组(n=10),非梗阻性无精子症组(n=42),少精子症组(n=20),弱精子症组(n=78),少弱精子症组(n=57),以及正常精子症组(n=18)。28例正常生育男性作为对照(生育组)。分别采用计算机辅助精液分析(CASA)系统进行精液参数分析,采用比色法检测精浆TAC水平。结果:生育组男性精浆TAC为(19.82±6.33)U,梗阻性无精子症组(1.71±1.33)U,非梗阻性无精子症组(12.73±9.44)U,少精子症组(10.85±6.64)U,弱精子症组(13.88±8.24)U,少弱精子症组(11.20±7.02)U,正常精子症组(18.07±8.73)U;与生育组精浆TAC[(19.82±6.33)U]相比,在各不育症组中,除正常精子症组精浆TAC与生育组差异无显著性外,其余各组均显著低于生育组(P<0.01)。精浆TAC与精子密度(r=0.182,P<0.05)和a级精子(r=0.150,P<0.05)呈显著正相关。结论:精浆中TAC水平与男性不育密切相关,精浆中过低的TAC水平可能是引起男性不育的病因之一。     

生育与不育男性血清和精浆褪黑素检测及其意义

目的 :检测生育与不育男性精浆褪黑素 (MLT)浓度并探讨在男性生育中的意义。　方法 :年龄为 2 6～ 36岁的生育男性 (18例 )和年龄为 2 3～ 36岁的不育男性 (99例 ) ,其中 ,后者又分为正常精子症组 (13例 )、少精子症组(2 7例 )、弱精子症组 (31例 )、少弱精子症组 (17例 )和少弱畸精子症组 (11例 )。分别采集静脉血和精液 ,采用酶联免疫吸附实验 (ELISA)检测血清和精浆中MLT浓度。　结果 :血清MLT浓度在生育与不育男性之间无显著性差异 ,各组精浆MLT浓度均低于相应的血清值。生育组精浆MLT浓度与各不育组相比无显著性差异 ,而少弱精子症组和少弱畸精子症组MLT浓度下降较为明显 ,但尚未达到统计学意义 (P >0 .0 5 )。　结论 :本研究结果表明 ,精浆MLT可能对精子功能具有一定作用 ,其具体作用机制尚需进一步深入的研究。     

Relation between immunosuppressive PGE(2) and IL-10 to pro-inflammatory IL-6 in seminal plasma of infertile and fertile men

In vitro studies have reported that seminal plasma of fertile men has more inhibitory mitogenic effect and higher suppressive activity on antibody-dependent cellular cytotoxicity than seminal plasma from infertile males. Is it possible that variations in the seminal plasma composition could explain these results? The present study was conducted to investigate the relation between immunosuppressive PGE(2) and IL-10 to pro-inflammatory IL-6 in seminal plasma of infertile and fertile men. Utilizing specific ELISA commercial kit, semen samples from 45 infertile undiagnosed and 25 fertile men were examined for the presence of PGE(2), IL-10, and IL-6. The IL-6 concentration in seminal plasma of infertile men was significantly higher than that of fertile men (p<.0 4). However, levels of IL-10 were lower for the semen of infertile men than that of fertile men (p<.04). No differences were observed in PGE(2) concentrations between both groups. Increase in pro-inflammatory cytokines, such as IL-6, and decrease in immunosuppressive ones, such as IL-10, could alter the tolerance to sperm cell in male and female tracts and reduce the favorable conditions to reach the fecundation and implantation. It is necessary to conduct further studies that include other pro- and anti-inflammatory substances to evaluate the importance of the immune balance of semen in human fertility.     

Analysis of lipid peroxidative levels in seminal plasma of infertile men by high-performance liquid chromatography

For the purpose to evaluate the significance of lipid peroxidative products on male infertility, the levels of malondialdehyde (MDA), which is one of the final products of lipid peroxidation in seminal plasma, were determined. Ninety-three male infertile patients were divided into obstructive azoospermic group (12 cases), non-obstructive azoospermic group (15 cases), oligozoospermic group (21 cases), asthenozoospermic group (19 cases), oligoasthenozoospermic group (16 cases) and oligoasthenoteratozoospermic group (10 cases). Eighteen fertile males were included in the control group. MDA concentrations of seminal plasma in the fertile and infertile men were detected by high-performance liquid chromatography (HPLC). The results showed that the concentration of MDA in seminal plasma differed significantly between the control group and all the infertile groups (P < 0.01) except the obstructive azoospermic group, between the oligoasthenozoospermic group and the oligozoospermic and asthenozoospermic groups (P < 0.01), and between the oligoasthenoteratozoospermic group and the oligozoospermic and asthenozoospermic groups (P < 0.01). MDA concentration of seminal plasma in the oligoasthenoteratozoospermic group differed significantly from that in the oligoasthenozoospermic group (P <0.05). The results suggested that detection of MDA concentrations in seminal plasma by HPLC has an indicative value on the diagnosis of male infertility induced by overproduction of reactive oxygen species in male reproductive system.     

Assessment of seminal granulysin in infertile men with varicocele

Varicocele has a common association with male infertility, but its exact role is still debated. Apoptosis has been suggested as one of the mechanisms of varicocele‐associated infertility. Granulysin is a molecule that plays a role in apoptosis with no previous study about its role in male infertility. This case‐controlled study aimed to assess seminal plasma granulysin level in infertile patients with varicocele. This study involved 90 men that were allocated into fertile normozoospermic men (n = 20), infertile men without varicocele (n = 30) and infertile men with varicocele (n = 40). These men were subjected to history taking, clinical examination, semen analysis and estimation of seminal granulysin. In general, seminal granulysin level was significantly elevated in infertile men compared with fertile men. Infertile men with varicocele showed significantly higher seminal granulysin compared with infertile men without varicocele, in bilateral varicocele cases and in grade III varicocele. Seminal granulysin level was negatively correlated with sperm concentration, sperm motility, sperm normal forms percentage and testicular volumes. It is concluded that increased seminal granulysin has a negative impact on spermatogenesis in infertile men in general and in infertile men associated with varicocele in particular.     

Assessment of seminal plasma laminin in fertile and infertile men

Aim： To assess laminin levels in the seminal plasma of infertile and fertile men, and to analyze the correlation of laminin levels with sperm count, age, sperm motility and semen volume. Methods： One hundred and twenty-five recruited men were equally divided into five groups according to their sperm concentration and clinical examination： fertile normozoospermia, oligoasthenozoospermia, non-obstructive azoospermia （NOA）, obstructive azoospermia （OA） and congenital bilateral absent vas deferens （CBAVD）. The patients＇ medical history was investigated and patients underwent clinical examination, conventional semen analysis and estimation of seminal plasma laminin by radioimmunoassay. Results： Seminal plasma laminin levels of successive groups were： 2.82 ± 0.62, 2.49 ± 0.44, 1.77 ± 0.56, 1.72 ± 0.76, 1.35 ± 0.63 U/mL, respectively. The fertile normozoospermic group showed the highest concentration compared to all infertile groups with significant differences compared to azoospermic groups （P 〈 0.05）. Testicular contribution was estimated to be approximately one-third of the seminal laminin. Seminal plasma laminin demonstrated significant correlation with sperm concentration （r = 0.460, P 〈 0.001） and nonsignificant correlation with age （r = 0.021, P = 0.940）, sperm motility percentage （r = 0.142, P = 0.615） and semen volume （r = 0.035, P = 0.087）. Conelusion： Seminal plasma laminin is derived mostly from prostatic and testicular portions and minimally from the seminal vesicle and vas deferens. Estimating seminal laminin alone is not conclusive in diagnosing different cases of male infertility.     

Seminal leucocyte subpopulations and sperm function in fertile and infertile Chinese men

The level of seminal leucocytes and the prevalence of leucocytospermia was determined in a group of fertile and infertile southern Chinese men in Hong Kong. Sixteen normal fertile semen donors and 49 men with male factor infertility were studied prospectively. None had antisperm antibodies and past or present evidence of genital tract infection. Seminal leucocytes and their subsets were analysed using monoclonal antibodies and an immunocytochemical alkaline phosphatase-anti-alkaline phosphatase conjugate technique. Seminal leucocytes were detectable in 94% and 86% of the fertile and infertile men respectively, with the predominant subset being granulocytes. Leucocytospermia (> 1 × 10⁶ leucocytes/ml) was found in only one of the 49 (2%) infertile men without clinical evidence of genito-urinary infection. Inverse correlations were observed between (1) the percentage of spermatozoa with normal morphology and the number of T-helper/inducer cells, (2) the linearity of sperm movement and the number of T-lymphocytes. In conclusion, the level of seminal leucocytes and the prevalence of leucocytospermia is low in infertile Chinese subjects. The effect of seminal leucocytes on sperm function in these subjects needs further evaluation.     

Beta-endorphin in serum and seminal plasma in infertile men

Aim:To access beta-endorphin levels in serum as well as seminal plasma in different infertile male groups.Methods:Beta-endorphin was estimated in the serum and seminal plasma by enzyme-linked immunosorbent assay(ELISA)method in 80 infertile men equally divided into four groups:non-obstructive azoospermia(NOA),obstructive azoosper-mia(OA),congenital bilateral absent vas deferens(CBVAD)and asthenozoospermia.The results were compared tothose of 20 normozoospermic proven fertile men.Results:There was a decrease in the mean levels of beta-endorphin in the seminal plasma of all successive infertile groups(mean±SD:NOA 51.30±27.37,OA 51.88±9.47,CBAVD 20.36±13.39,asthenozoospermia 49.26±12.49 pg/mL,respectively)compared to the normozoospermicfertile control(87.23±29.55 pg/mL).This relation was not present in mean serum level of beta-endorphin betweenfour infertile groups(51.09±14.71,49.76±12.4,33.96±7.2,69.1±16.57 pg/mL,respectively)and the fertilecontrol group(49.26±31.32 pg/mL).The CBVAD group showed the lowest seminal plasma mean level of beta-endorphin.Testicular contribution of seminal beta-endorphin was estimated to be approximately 40%.Seminal beta-endorphin showed significant correlation with the sperm concentration(r=0.699,P=0.0188)and nonsignificantcorrelation with its serum level(r=0.375,P=0.185)or with the sperm motility percentage(r=0.470,P=0.899).Conclusion:The estimation of beta-endorphin alone is not conclusive to evaluate male reproduction as there aremany other opiates acting at the hypothalamic pituitary gonadal axis.(Asian J Androl 2006 Nov;8:709-712)     

Evaluation of tissue factor antigen level in human seminal plasma

We measured the seminal plasma levels of tissue factor (TF) and interleukin-6 (IL-6) in men and examined their relationship with sperm concentration and motility. The study comprised 71 patients in three groups: an infertile group with ( n=11) and without ( n=50) leukocytospermia and a fertile group ( n=10). The seminal plasma levels of TF were significantly higher in the infertile patients than in the fertile ones. The seminal plasma levels of both TF and IL-6 were significantly higher in the infertile patients with leukocytospermia than in those without leukocytospermia. In 54 nonazoopermic cases the seminal plasma levels of TF were significantly correlated with the sperm concentration and sperm motility. Further studies are necessary to clarify the role of TF in human fertilization.